Transobturator Tape Operation Is More Effective in Premenopausal Women than in Postmenopausal Women with Stress Incontinence

Polat Dursun,Tevfik Berk Bildaci,Hulusi Bulent Zeyneloglu,Esra Kuscu,Ali Ayhan 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.9

Purpose: Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared. Materials and Methods: We assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire. Results: The mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027). Conclusions: The TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results. Purpose: Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared. Materials and Methods: We assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire. Results: The mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027). Conclusions: The TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results.

Standardized Uptake Values Highly Correlate with Tumor Size and Fuhrman Grade in Patients with Clear Cell Renal Cell Carcinoma

Polat, Emre Can,Otunctemur, Alper,Ozbek, Emin,Besiroglu, Huseyin,Dursun, Murat,Ozer, Kutan,Horsanali, Mustafa Ozan Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

Background: We investigated the correlation between standardized uptake value (SUVmax), tumor size and Fuhrman grade in patients with renal cell carcinoma (RC). Materials and Methods: We retrospectively analyzed the data of 54 patients with clear cell renal cell carcinoma histopathologically diagnosed who underwent fluorine-18 fluoro-2 deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) between January 2005 and March 2014. Results: Avarage tumor sizes were $5.64{\pm}1.85$, $6.85{\pm}2.24$ and $7.98{\pm}2.45$ in low, medium and high SUVmax groups, respectively. The Spearman's correlation coefficient between the tumor size and SUVmax was 0.385 (p=0.004) and between the Fuhrman grade and SUVmax was 0.578 (p<0.001). Conclusions: SUVmax appears highly correlated with tumor size and Fuhrman grade in patients with histopathologically confirmed clear cell RC. Multicenter studies are needed to provide larger series for more accurate results.

Renal Cell Carcinoma is More Aggressive in Turkish Patients with the Metabolic Syndrome

Ozbek, Emin,Otunctemur, Alper,Sahin, Suleyman,Dursun, Murat,Besiroglu, Huseyin,Koklu, Ismail,Polat, Emre Can,Erkoc, Mustafa,Danis, Eyyup,Bozkurt, Muammer Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

Impact of Treatment Strategies on Local Control and Survival in Uterine Carcinosarcomas in Turkey

Kucukoztas, Nadire,Dizdar, Omer,Rahatli, Samed,Dursun, Polat,Yalcin, Selim,Altundag, Ozden,Ozen, Ozlem,Reyhan, Nihan Haberal,Tarhan, Cagla,Yildiz, Ferah,Ayhan, Ali Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.5

Background: The purpose of this study was to determine the clinical characteristics, patterns of recurrence and survival outcomes in patients with uterine carcinosarcomas treated in our institution. Materials and Methods: Records of 26 patients diagnosed between 2007 and 2011 with uterine carcinosarcoma were retrospectively evaluated for demographic features, tumor characteristics, treatment regimens and patient outcomes in terms of DFS and OS Results: Median age was 61 (range 43-78). 10 patients (38%) had stage I disease at diagnosis, 3 (12%) had stage II, 4 (15%) had stage III and 9 (35%) had stage IV. Sixteen patients (62%) received chemotherapy with paclitaxel and carboplatin for 6 cycles. One patient underwent radiotherapy. Median follow up was 17 months. Sixteen patients relapsed and 13 died during follow up. Considering recurrence, 5 out of 16 patients had lung metastases, one had brain metastases and 9 had only intraabdominal recurrence. The 3 year DFS was 37% and the 3 year OS was 30%. Conclusions: Our data show that uterine carcinosarcomas tend to be at advanced stage at diagnosis and despite the use of chemotherapy, overall prognosis is poor. Surgery remains the mainstay of treatment. More effective adjuvant strategies are needed to reduce relapse and death rates.

Antimicrobial Activities of Essential Oil and Hexane Extract of Florence Fennel [Foeniculum vulgare var. azoricum (Mill.) Thell.] Against Foodborne Microorganisms

Bülent Çetin,Hakan Özer,Ahmet Cakir,Tas¸kin Polat,Atilla Dursun,Ebru Mete,Erdog˘an O¨ ztu¨rk,Melek Ekinci 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.1

The objective of this study was to determine the chemical compositions of the essential oil and hexane extract isolated from the inflorescence, leaf stems, and aerial parts of Florence fennel and the antimicrobial activities of the essential oil, hexane extract, and their major component, anethole, against a large variety of foodborne microorganisms. Gas chromatography and gas chromatography-mass spectrometry analysis showed that the essential oils obtained from inflorescence, leaf stems, and whole aerial parts contained (E)-anethole (59.28–71.69%), limonene (8.30–10.73%), apiole (trace to 9.23%), β-fenchyl acetate (3.02–4.80%), and perillene (2.16–3.29%) as the main components. Likewise, the hexane extract of the plant sample exhibited a similar chemical composition, and it contained (E)-anethole (53.00%), limonene (27.16%), γ-terpinene (4.09%), and perillene (3.78%). However, the hexane extract also contained less volatile components such as n-hexadecanoic acid (1.62%), methyl palmitate (1.17%), and linoleic acid (1.15%). The in vitro antimicrobial assays showed that the essential oil, anethole, and hexane extract were effective against most of the foodborne pathogenic, saprophytic, probiotic, and mycotoxigenic microorganisms tested. The results of the present study revealed that (E)-anethole, the main component of Florence fennel essential oil, is responsible for the antimicrobial activity and that the essential oils as well as the hexane extract can be used as a food preservative. This study is the first report showing the antimicrobial activities of essential oil and hexane extract of Florence fennel against probiotic bacteria.

Comparison of three different risk-stratification models for predicting lymph node involvement in endometrioid endometrial cancer clinically confined to the uterus

Vakkas Korkmaz,Mehmet Mutlu Meydanli,Ibrahim Yalçın,Mustafa Erkan Sarı,Hanifi Sahin,Eda Kocaman,Ali Haberal,Polat Dursun,Tayfun Güngör,Ali Ayhan 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6

Objective: To compare the clinical validity of the Gynecologic Oncology Group-99 (GOG-99), the Mayo-modified and the European Society for Medical Oncology (ESMO)-modified criteria for predicting lymph node (LN) involvement in women with endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: A total of 625 consecutive women who underwent comprehensive surgical staging for endometrioid EC clinically confined to the uterus were divided into low- and high-risk groups according to the GOG-99, the Mayo-modified, and the ESMO-modified criteria. Lymphovascular space invasion is the cornerstone of risk stratification according to the ESMO-modified criteria. These 3 risk stratification models were compared in terms of predicting LN positivity. Results: Systematic LN dissection was achieved in all patients included in the study. LN involvement was detected in 70 (11.2%) patients. LN involvement was correctly estimated in 51 of 70 LN-positive patients according to the GOG-99 criteria (positive likelihood ratio [LR+], 3.3; negative likelihood ratio [LR−], 0.4), 64 of 70 LN-positive patients according to the ESMO-modified criteria (LR+, 2.5; LR−, 0.13) and 69 of the 70 LN-positive patients according to the Mayo-modified criteria (LR+, 2.2; LR−, 0.03). The area under curve of the Mayo-modified, the GOG-99 and the ESMO-modified criteria was 0.763, 0.753, and 0.780, respectively. Conclusion: The ESMO-modified classification seems to be the risk-stratification model that most accurately predicts LN involvement in endometrioid EC clinically confined to the uterus. However, the Mayo-modified classification may be an alternative model to achieve a precise balance between the desire to prevent over-treatment and the ability to diagnose LN involvement.

Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

Rahatli, Samed,Dizdar, Omer,Kucukoztas, Nadire,Oguz, Arzu,Yalcin, Selim,Ozen, Ozlem,Reyhan, Nihan Haberal,Tarhan, Cagla,Yildiz, Ferah,Dursun, Polat,Altundag, Ozden,Ayhan, Ali Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.9

Background: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates although the majority of them received no adjuvant treatment. Surgery alone may be sufficient for most patients with this stage of endometrial cancer.